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Popular systems use pneumatic compression to flush waste buildup in your cells and relieve muscle soreness. But is the price tag worth it?

Once considered a medical-grade device, compression boots have gone mainstream—and some athletes consider them an absolute necessity. These days, you can find air-filled boots like NormaTec, Therabody, and AIR RELAX at gyms, studios, and physical therapy offices, and, depending on how much disposable cash you have laying around, you can even buy your own. But are they worth the time or financial investment?

First, a quick science lesson on how they work: “Your body is constantly generating metabolic waste as it produces and uses energy, and that waste gets circulated throughout your blood,” explains Kathleen Leninger, DPT, a physical therapist at Custom Performance in New York, NY. “Because your legs are below your heart, it’s harder for the heart to pump that waste from your legs to your lymph system, which helps get rid of it.”

The idea behind compression is pretty simple: It helps your system increase blood flow to certain areas, which helps circulate that waste to get rid of it faster. But not all compression is created equal. Below, check out some of the most popular compression boot systems and learn about the benefits and downsides of these high-tech recovery tools.

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With 7 intensity levels, these boots connect to the Hyperice App via Bluetooth® (for automated speed control) and have a 1-year limited warranty.

The system has an adjustable range of 20 to 100 mmHg, 20 cycles in 20 minutes, and a 1-year limited warranty.

These boots release 15 liters of air per minute, with four different pressure levels and three different modes. Includes a 1-year limited warranty.

With pressure of up to 250 mmHg, 6 massage programs, isolation mode, and remote control. It includes a 2 years guarantee and lifetime servicing.  

There are two types of compression athletes use: compression and intermittent pneumatic compression. Compression socks, which are generally tighter at the bottom and get progressively looser, use regular compression; they work by squeezing the legs, improving blood flow from the feet upwards and reducing swelling and discomfort. Intermittent pneumatic compression devices, like compression boots, mechanically inflate and deflate segments of a sleeve at different times to do the same thing.

Picture it this way: “If you have a tube of toothpaste and the only toothpaste left is all the way at the bottom, you have to squeeze the top stuff out first, then you move to the next chamber until you work your way to the bottom,” says Leninger. That’s similar to how intermittent pneumatic compression devices work.

That’s not to say there’s anything wrong with using compression socks; you can just get results quicker with intermittent pneumatic compression devices. “The sheer amount of compression you’ll receive from a mechanical device will work exponentially faster than socks,” says Eric Madia, head of sports science at the Sports Performance Lab. Think about it as an active stretch versus a passive stretch: The socks are a passive way of providing compression, while pneumatic compression devices are more active.

If you’ve ever worn a pair of these puffy sleeves, you know it just feels good—kind of like a massage. And “if the only benefit you get is sitting down and relaxing for 20 minutes while you use them, that’s still worth it,” says Leninger. But there are scientifically-proven benefits when it comes to exercise recovery.

For starters, the boots enhance blood flow and circulation. Intermittent compression applied during recovery from exercise resulted in increased limb blood flow, potentially contributing to changes in exercise performance and recovery, a 2018 study in the Journal of Applied Physiology found.

They can also reduce swelling. When you do a hard ride, whether it’s an XC mountain bike race, a 100-mile gravel grinder, or an eye-popping Tabata sprint session, your muscles experience micro tears. “You may not even notice it, but edema, or swelling, occurs when your body starts to repair those microtears,” says Leninger. That swelling will go away naturally if you’re recovering appropriately (think: staying off your feet, elevating your legs, resting,) but compression can help shorten the amount of rest you may need by preventing swelling from pooling in a particular area when you have to go straight from a ride into life.

“When that metabolic waste from a workout is sitting there in your cells taking up space, that’s space that your blood could use to bring new nutrients to in the muscle,” says Leninger. The more nutrients your muscles are getting, the faster they can repair and rebuild.

One 2016 study on ultramarathon runners published in the Journal of Orthopaedic & Sports Physical Therapy found that post-exercise pneumatic compression therapy offered the same benefits as post-exercise massage, specifically lowering overall muscular fatigue. And daily treatments using a pneumatic compression device reduced recovery time from DOMS when compared to a continuously worn compression sleeve, according to research published in 2018 in the International Journal of Exercise Science.

In one study of athletes performing 60-second all-out cycling sprints under heavy resistance, researchers found that pneumatic compression therapy worked as well as an active recovery spin for reducing blood lactate levels. This is why some riders use them when they’re short on time—since you can multitask in the boots.

Another study on 24 highly trained Olympic athletes (half women, half men) reported that those who received a 15-minute session of pneumatic compression therapy after their morning training session enjoyed a reduction in their pain pressure threshold (a scientific way of saying their muscles were less sensitive when you pressed on them) immediately after the session and for the remainder of the day after the afternoon practice. Their peers who recovered without the compression therapy did not experience any such pain relief.

It’s worth noting that though the physiological research is largely promising, research on performance metrics is lacking. In other words, studies show that you will likely feel better, but it’s harder to find research to confirm that you’ll perform better...though the two may go hand in hand for some riders.

“I bought the Normatec boots because after trying them, I loved the compression on my tired legs,” says Kaysee Armstrong, who races with the Trail Squad as part of Liv’s pro team (and who is not sponsored by Normatec). “After a long day of travel or training, it helps me to recover, and on the days where I’m lazy [and not feeling like a recovery ride], it helps me to be lazy and incentivizes me to sit down and put my legs up and recover.”

The only real negative to compression boots? They can be pretty pricey. Some of the most popular systems cost around $1,000, which is a lot of money for the average rider.

On a scientific front, “there are very few studies, if any, that show a negative effect for athletes,” says Leninger, which can make you feel better about the splurge.

Another downside is that the systems are not always intuitive for the average user. Whereas your physical therapist may know exactly what setting to put you on depending on your current training and feedback, it’s not always so obvious for the layperson who is using boots at home.

This should be a no-brainer, but the more work you do, the more recovery you need. “In general, the harder your effort, the more metabolites, build, and waste you’re going to need to clear from your cells,” says Madia. Slip them on for post-speed work, post-long ride, century training, or after whatever workout is most taxing, and you’re more likely to see the benefits. They can also be especially helpful when you know you have two strenuous efforts back to back, says Leninger.

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